Provider Demographics
NPI:1992524276
Name:YANNEY, SARA RUTH (MA, LPC, R-DMT)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:RUTH
Last Name:YANNEY
Suffix:
Gender:F
Credentials:MA, LPC, R-DMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5125 WILLIAMS FORK TRL APT 104
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-3453
Mailing Address - Country:US
Mailing Address - Phone:720-378-8410
Mailing Address - Fax:
Practice Address - Street 1:1440 W 29TH ST STE 100
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-2459
Practice Address - Country:US
Practice Address - Phone:970-775-7061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-04
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0021218101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional